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Sökning: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) hsv:(Psykiatri) > (2000-2009) > Gustafson Lars

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1.
  • Passant, Ulla, et al. (författare)
  • Psychiatric Symptoms and Their Psychosocial Consequences in Frontotemporal Dementia.
  • 2005
  • Ingår i: Alzheimer Disease and Associated Disorders. - 0893-0341. ; 19 Suppl 1, s. 15-18
  • Tidskriftsartikel (refereegranskat)abstract
    • Based on a retrospective study of 19 neuropathologically verified cases with frontotemporal dementia (FTD), neuropsychiatric symptoms related to behavioral disturbances and their psychosocial consequences were studied. The results indicate that frontotemporal dementia is often misdiagnosed early in the clinical course. Behavioural features with impaired social interactions, impaired personal regulation, and loss of insight were seen in all patients. The psychosocial consequences reported in this paper challenge future research in frontotemporal dementia.
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2.
  • Wallin, Åsa, et al. (författare)
  • Five-year outcome of cholinergic treatment of Alzheimer's disease: Early response predicts prolonged time until nursing home placement, but does not alter life expectancy
  • 2004
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 18:2, s. 197-206
  • Tidskriftsartikel (refereegranskat)abstract
    • Fifty consecutive outpatients with Alzheimer’s disease (AD) received treatment with the cholinesterase inhibitor tacrine in an open longitudinal study. Assessments using Mini-Mental State Examination, Alzheimer’s Disease Assessment Scale – cognitive subscale, and a global rating were made at baseline and at 6, 12, 24, 36, 48 and 60 months. Three outcome groups were characterized: responders, unchanged and deteriorated. Additional outcome measures were time until nursing home placement, and mortality rate. At 6 months –75%, at 12 months –42%, at 24 months –20%, and after that 10% of the patients still on medication had improved or remained stable. The mortality rate did not differ between the outcome groups. Response to tacrine treatment at 6 or 12 months was found to predict a prolonged time until nursing home placement. No predictors for a positive treatment response could be identified at baseline.
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3.
  • Andin, Ulla, et al. (författare)
  • A Clinico-Pathological Study of Heart and Brain Lesions in Vascular Dementia.
  • 2005
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 19:4, s. 222-228
  • Tidskriftsartikel (refereegranskat)abstract
    • All vascular dementia (VaD) cases, neuropathologically verified in a longitudinal prospective dementia project, were classified according to the vascular brain lesion type and related to the dementia type and cardiovascular pathology. From 1976 to 1995, there were 175 VaD cases, 49 of which were pure, without Alzheimer pathology and only one type of cerebrovascular lesion. Furthermore, it was found that 6 cases suffered hypoxic hypoperfusive disease, while 7 were found to have large vessel disease and 36 small vessel disease. In addition to Alzheimer pathology, more than one type of vascular brain pathology was found in the remaining 126 cases. In these cases, diagnosed in accordance with the predominant type of VaD, hypoxic-hypoperfusive lesions were found in 55, large vessel lesions in 50 and small vessel lesions in 110 cases. It should be stressed that 87% of all cases with hypoxic hypoperfusive lesions also had Alzheimer pathology. Cardiovascular and aortic pathologies were more prevalent in small vessel dementia than in the other VaD groups. Clinically diagnosed arterial hypertension was significantly associated with small vessel dementia, but not with hypoxic-hypoperfusive dementia. Cardiovascular symptoms varied considerably in frequency between different dementia groups. VaD is a heterogeneous group regarding lesions caused by different pathophysiological mechanisms and with different combinations of brain pathologies. It is therefore necessary to identify the various types of vascular brain lesions for a correlation with clinical symptoms and for diagnostic purposes in the search for risk factors and therapeutic strategies.
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5.
  • Gräsbeck, Anne, et al. (författare)
  • Dementia in First-Degree Relatives of Patients with Frontotemporal Dementia. A Family History Study.
  • 2005
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 19:2-3, s. 145-153
  • Tidskriftsartikel (refereegranskat)abstract
    • Several studies have found a clustering of dementia in relatives of patients with frontotemporal dementia (FTD). This study analysed the familial aggregation of FTD specifically as well as the occurrence of dementia in general in first-degree relatives of patients with FTD. A family history study was carried out on 478 first-degree relatives of 74 index patients suffering from FTD. Cases of organic dementia and of FTD were diagnosed according to internationally accepted diagnostic criteria. Age- and sex-specific incidences of organic dementia and of FTD were calculated as was the proportion of FTD in relation to organic dementia in general; comparisons with clinical and population studies were made. There was a tenfold increase in the incidence of FTD in the first-degree relatives of FTD patients compared with the incidence of FTD in a population study. The proportion of FTD in relation to all types of organic dementia was much higher in relatives of FTD patients compared to the corresponding proportions in clinical and population-based studies. There was a small, non-significant difference between the present family history study and the population studies as regards the incidence of organic dementia. The findings suggest that hereditary and/or shared environmental factors are strongly involved in the aetiology of FTD. There were no indications of familial clustering of organic dementia in general in relatives of FTD patients.
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8.
  • Risberg, Jarl, et al. (författare)
  • A new tomographic technique for absolute measurements of white and gray matter blood flow
  • 2004
  • Ingår i: Proceedings of the 8th Nordic Meeting in Neuropsychology, Turku, Finland, August 26–29, 2004, 85.
  • Konferensbidrag (refereegranskat)abstract
    • Objective. Most methods for measurements of the regional cerebral blood flow are unable to provide absolute blood flow values. Until now interest has been focused on measurement of the gray matter blood flow, while the white matter blood flow has been rather neglected. The aim of the present project was to develop and evaluate an improved method for reliable tomographic measurements of absolute white and gray matter blood flow Method. The new tomographic method (modified Xe-SPECT) is based on an extension of the period of 133Xe inhalation from one to eight minutes followed by 22 instead of four minutes of breathing of ambient air. This gives a markedly enhanced signal from the white matter and better basis for correct quantification of the blood flow. The arrival and clearance of the tracer are recorded by a three head gamma camera system that provides flow maps with a spatial resolution of about one cm. Results The new method has been evaluated in 33 healthy younger and older (around 70 years) subjects as well as in a group of elderly patients with organic dementia. Our preliminary findings indicate that new and clinically valuable information is obtained by the improved Xe-SPECT method.
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9.
  • Andersson, Edith, et al. (författare)
  • Acute confusional state in elderly orthopaedic patients: factors of importance for detection in nursing care
  • 2001
  • Ingår i: International Journal of Geriatric Psychiatry. - 1099-1166. ; 16:1, s. 7-17
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: The aims of this study were to identify factors of significance in the development of acute confusional state (ACS) and the differences between patients who developed ACS and those who did not. METHOD AND RESULTS: Assessment, observations and interviews with 505 patients admitted to an orthopaedic clinic revealed that 51 patients developed ACS during their in-hospital stay. Patients admitted for hip fracture had a higher incidence of ACS (20.2%) than patients admitted for elective surgery for coxarthros or gonarthros (3.6%). The highest hazard ratio for ACS was several other physical diseases 15.94 (CI: 4.60-55.31 and p-value <0.00001) and the lowest was age 1.10 (CI: 1.04-1.15 and p-value <0.0002). The ACS lasted from 1 to 9 days, and patients had one (N=42), two (N=8) or three episodes (N=1) of confusion during their stay on the ward. More patients who developed ACS before surgery had two or more confusional episodes and emergency patients developed ACS more rapidly. The ACS lasted longer in patients with a higher score on the OBS scale at admittance and with rapid development of ACS. CONCLUSIONS: Acuteness in the situation seems an important risk indication for ACS in the elderly. Awareness of factors associated with the development of ACS makes it possible to more systematically identify those at risk, for instance by systematic assessment in the first interview with the patient on admission to hospital.
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